Current Topics in Medical Mycology pp 199-238
Epidemiology of Coccidioidomycosis
Coccidioidomycosis (San Joaquin Fever or Valley Fever) is an infection caused by the soil-inhabiting fungus Coccidioides immitis. The infection is usually acquired by inhalation of the arthroconidia, rarely by their introduction percutaneously. Although many infections are asymptomatic, symptomatic primary acute infection usually appears to be confined to the lungs and regional (thoracic) lymph nodes. Recovery is often complete although occasionally (5–10% of symptomatic cases and an unknown portion of asymptomatic cases) the patient is left with a pulmonary residuum: cavity, solid coccidioidoma, bronchiectasis, or fibrosis. In a few cases, C. immitis is borne beyond the thoracic (including supraclavicular) lymphatic system leading to a serious, disseminated form of the disease.
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